ABSTRACT
@#Objective: The objective of this study is to determine the frequency and correlates of insomnia among elderly patients presenting to family medicine clinics at an academic center in Karachi, Pakistan. Study design: This is a cross-sectional study. Place and duration of study: The study was conducted at the Outpatient Family Medicine Clinics at Aga Khan University Hospital between February 2013 and June 2013. Methodology: Patients 60 years old and above were recruited (n=152) through non- probability consecutive sampling. Information was collected on a pretested structured questionnaire on demographics, insomnia symptoms, medical co-morbidities, lifestyle factors and sleep disorders. Data was analyzed on SPSS 19. Proportions and the Chi-Square test were used in the analyses, along with binary logistic regression. Results: The mean age of the participants was 65.68 years, and 38.80% of the participants were male and 61.20% were female. The prevalence of insomnia was 42.1%. It was more common in women than in men (64.10% vs. 35.9%). Increasing age [ORadj: 4.54; 95%CI: 1.85-11.17], being divorced/widowed [ORadj: 10.26; 95%CI: 2.79- 37.73] and having an average household income of over Rs.50, 000, were significantly related to insomnia. The other factors associated with insomnia were Gastro Esophageal Reflux Disease [ORadj: 4.30; 95% CI: 1.67-11.04], depression [ORadj: 2.88, 95% CI: 1.13-7.33], caffeine consumption [ORadj: 6.50; 95% CI: 2.27-18.57], and cigarette smoking close to bed time [ORadj: 4.78; 95% CI: 0.88-25.90]. Conclusion: The study showed that older adults with multiple diseases were at high risk of insomnia. Certain life style practices enhanced the risk; hence, physicians should incorporate sleep history and tailor treatment to target both insomnia and related factors to optimize quality of life.
ABSTRACT
Objective: To describe by means of a survey the availability, functioning and quality of health care delivery system in the public sector health districts of Kuwait. Methods: A descriptive cross sectional survey was conducted in five health districts of Kuwait and data collection was done using structured questionnaires. The survey was based on general observation, examination of facility records, and interviews with facility personnel. The data was entered in SPSS-version 19.0, and analysis was based on type of the health facilities and district with focus on predefined indicators Results: All the health centres in the five health districts were targeted to obtain information. Majority of health service centre suggested that training for Non-Communicable Diseases and related factors should be provided. Nearly all the centers assumed that electronic health record [EHR] is suitable for recording data regarding Non-Communicable Diseases. Nonetheless, there is need for health promotion and obesity prevention clinics in almost all the health districts. Conclusion: There is a need for cancer screening clinics in all the districts of Kuwait. New researches and surveillance systems have been developed for Non-Communicable Diseases which can assist in lowering the incidence of such diseases in the country
ABSTRACT
Objective: Child abuse is one of the major challenges for health care providers. This study was conducted to determine the burden of child abuse [physical and emotional] and the factors associated with it in an urban city of Pakistan
Methods: This cross-sectional study was conducted in primary care clinics affiliated with a tertiary care hospital in Karachi, Pakistan between March to December 2010. Mothers with children aged between 6 and 12 years were included in the study. Those mothers' suffering from any acute illness like high grade fever, were excluded. A total of 412 mothers were recruited through consecutive sampling and written informed consent was taken. A pre-tested questionnaire was used to seek information about child abuse. Data was analyzed using SPSS version 19 and multivariable logistic regression was used to identify the factors [age, gender of child, family structure, educational status of parents, and mother's perception of her home environment] associated with child abuse
Findings: Of the total 412 mothers, final analysis was conducted on 379 mothers. In all, 32.5% of children had been abused, 25.5% physically and 17.9% emotionally. Abuse was reported more among children whose mothers had minimal or no schooling [P=0.02], who were abused by their husbands [P<0.001], not satisfied with their marital life [P<0.001], and stressful home environment [P=0.02]. In the multivariate analysis, the factors found to be independently associated with child abuse were mothers abused by their husbands [AOR=4.2; 95%CI: 2.2-7.9] and child being a girl [AOR=8.7; 95%CI: 4.5-16.8]
Conclusion: The prevention of child abuse can be achieved through comprehensive, multifaceted and integrated approaches requiring joint efforts by the government, policy makers, stake holders, social workers, educationists, and public health practitioners
ABSTRACT
Fibromyalgia Syndrome [FMS] is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. It is also characterized by restless sleep, tiredness, fatigue, anxiety, depression, and disturbances in bowel functions. The etiology of fibromyalgia remains unknown, but recent advances and discoveries have helped to unravel some of the mysteries of this disease. Research highlights some of the biochemical, metabolic, and immunoregulatory abnormalities associated with fibromyalgia. Management of FMS at the present time is very difficult as it has multiple etiological factors and psychological predispositions; however, a patient centered approach is essential to handle this problem